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Therapeutic ultrasound as treatment for chronic rhinosinusitis: preliminary observations

Published online by Cambridge University Press:  06 January 2010

D Young ,
R Morton  and
J Bartley
D Young
Affiliation:
Division of Otolaryngology-Head and Neck Surgery, Counties-Manukau District Health Board, Auckland, and the Department of Surgery, South Auckland Clinical School, University of Auckland, New Zealand
R Morton
Affiliation:
Division of Otolaryngology-Head and Neck Surgery, Counties-Manukau District Health Board, Auckland, and the Department of Surgery, South Auckland Clinical School, University of Auckland, New Zealand
J Bartley*
Affiliation:
Division of Otolaryngology-Head and Neck Surgery, Counties-Manukau District Health Board, Auckland, and the Department of Surgery, South Auckland Clinical School, University of Auckland, New Zealand
*
Address for correspondence: Mr Jim Bartley, Otolaryngologist, 10 Owens Rd, Epsom, Auckland 1023, New Zealand. Fax: +649 631 0478 E-mail: [email protected]
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Abstract

Background:

Bacterial biofilms have been implicated in the pathogenesis of chronic rhinosinusitis. In the laboratory setting, ultrasound is effective in disrupting such biofilms; however, few clinical studies have evaluated the role of therapeutic ultrasound in chronic rhinosinusitis.

Objective:

This study was performed to investigate the short-term effectiveness of therapeutic ultrasound as a treatment modality for chronic rhinosinusitis.

Methods:

Twenty-two patients with a positive history of chronic rhinosinusitis, according to the criteria set out by the Rhinosinusitis Task Force, together with a previous computed tomography scan compatible with a diagnosis of chronic rhinosinusitis, and who had failed previous, aggressive medical management, were treated with therapeutic pulsed ultrasound at 1 MHz two to three days per week for six sessions. Patients completed an assessment of individual sinus symptom severity and the 20-Item Sino-Nasal Outcome Test questionnaire before treatment, prior to session four and after completion of session six.

Results:

Two patients were unable to complete the study protocol. After completion of session six, 18 patients had experienced improvement in symptoms, while two patients noted a worsening of symptoms. Median percentage improvement of the total overall symptom score was 16.7 per cent (Wilcoxon signed rank, p < 0.001). The 20-Item Sino-Nasal Outcome Test score improved by 34.1 per cent (Wilcoxon signed rank, p < 0.0001).

Conclusion:

This study demonstrated a significant improvement in chronic rhinosinusitis symptoms after a six-session course of pulsed ultrasound therapy. Treatment with ultrasound alone or combined with antibiotics may provide a strategy to target biofilms on the sinus mucosa. Therapeutic ultrasound warrants further investigation as a potential treatment modality for chronic rhinosinusitis.

Keywords

SinusitisUltrasound TherapyBacterial Biofilms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 5 , May 2010 , pp. 495 - 499
Copyright
Copyright © JLO (1984) Limited 2009

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References

1Benninger, MS, Ferguson, BJ, Hadley, JA, Hamilos, DL, Jacobs, M, Kennedy, DW et al. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg 2003;129(Suppl. 3):S1–32CrossRefGoogle ScholarPubMed
2Kilty, SJ, Desrosiers, MY. The role of bacterial biofilms and the pathophysiology of chronic rhinosinusitis. Curr Allergy Asthma Rep 2008;8:227–33CrossRefGoogle ScholarPubMed
3Hunsaker, DH, Leid, JG. The relationship of biofilms to chronic rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg 2008;16:237–41CrossRefGoogle ScholarPubMed
4Post, JC, Hiller, NL, Nistico, L, Stoodley, P, Ehrlich, GD. The role of biofilms in otolaryngologic infections: update 2007. Curr Opin Otolaryngol Head Neck Surg 2007;15:347–51CrossRefGoogle ScholarPubMed
5Psaltis, AJ, Wietzel, EK, Ha, KR, Wormald, P-J. The effect of bacterial biofilms on post-sinus surgical outcomes. Am J Rhinol 2008;22:1–6CrossRefGoogle ScholarPubMed
6Bartley, J, Young, D. Ultrasound as a treatment for chronic rhinosinusitis. Med Hypotheses 2009;73:15–17CrossRefGoogle ScholarPubMed
7Le, T, Psaltis, A, Tan, LW, Wormald, PJ. The efficacy of topical antibiofilm agents in a sheep model of rhinosinusitis. Am J Rhinol 2008;22:560–7CrossRefGoogle Scholar
8Chiu, AG, Palmer, JN, Woodworth, BA, Doghramji, L, Cohen, MB, Prince, A et al. Baby shampoo nasal irrigations for the symptomatic post-functional endoscopic sinus surgery patient. Am J Rhinol 2008;22:34–7CrossRefGoogle ScholarPubMed
9Kahn, J. Principles and Practice of Electrotherapy. New York: Churchill Livingstone, 2000Google Scholar
10Ansari, NN, Naghdi, S, Farhadi, M, Jalaie, S. A preliminary study into the effect of low-intensity pulsed ultrasound on chronic maxillary and frontal sinusitis. Physiother Theory Pract 2007;23:211–18CrossRefGoogle ScholarPubMed
11Ansari, NN, Naghdi, S, Farhadi, M. Physiotherapy for chronic rhinosinusitis: the use of continuous ultrasound. Int J Ther Rehabil 2007;14:306–10CrossRefGoogle Scholar
12Naghdi, S, Ansari, NN, Farhadi, M. A clinical trial on the treatment of chronic rhinosinusitis with continuous ultrasound. J Phys Ther Sci 2008;20:233–8CrossRefGoogle Scholar
13Piccirillo, JF, Merritt, MG Jr, Richards, ML. Psychometric and clinimetric validity of the 20-Item Sino-Nasal Outcome Test (SNOT-20). Otolaryngol Head Neck Surg 2002;126:41–7CrossRefGoogle ScholarPubMed
14Lund, VJ, Kennedy, DW. Staging for rhinosinusitis. Otolaryngol Head Neck Surg 1997;117:S35–40CrossRefGoogle ScholarPubMed
15Jonsson, P, Sahlstrand-Johnson, P, Holmer, NG, Persson, HW, Jannert, M, Jansson, T et al. Feasibility of measuring acoustic streaming for improved diagnosis of rhinosinusitis. Ultrasound Med 2008;34:228–38CrossRefGoogle ScholarPubMed
16Heges, MM, Lewis, J, Lunec, J, Cramp, WA. The effect of ultrasound at 1.5 MHz on Escherichia coli. Int J Radiat Biol 1980;37:103–8Google Scholar
17Scherba, G, Weigel, RM, O'Brien, WD. Quantitative assessment of the germicidal efficacy of ultrasonic energy. Appl Environ Microbiol 1991;57:2079–84CrossRefGoogle ScholarPubMed
18Quian, Z, Sagers, RD, Pitt, WG. The effect of ultrasonic frequency upon enhanced killing of P. aeruginosa biofilms. Ann Biomed Eng 1997;25:69–76CrossRefGoogle Scholar
19Geerlings, SE, Hoelepman, AI. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol Med Microbiol 1999;26:259–65CrossRefGoogle ScholarPubMed
20Pitt, WG, Ross, SA. Ultrasound increases the rate of bacterial cell growth. Biotechnol Prog 2003;19:1038–44CrossRefGoogle ScholarPubMed